Partial Nephrectomy for T1b/T2 Renal Mass

Main Article Content Mohamed Sharafeldeen

Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt


Wael Sameh

Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt


Vahid Mehrnoush

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Amer Alaref

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Radu Rozenberg

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Asmaa Ismail

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Hazem Elmansy

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Walid Shahrour

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Ahmed Zakaria

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Osama Elmeslemany

Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt


Nishigandha Burute

Northern Ontario School of Medicine, Thunder Bay, ON, Canada


Anatoly Shuster

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Owen Prowse

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Ahmed Kotb

Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada


Keywords

Partial nephrectomy, radical nephrectomy, large renal mass, nephrometry score, eGFR

Abstract

The aim of our study was to show our short-term experience in managing large renal masses (cT1b/T2) through partial nephrectomy (PN) over the last 3 years. Retrospective data collection for all patients managed by PN for renal masses larger than 4 cm over the last 3 years. Epidemiological data were collected. Surgical data including surgical and ischemic times as well as intra and postoperative complications were collected. Pre- and postoperative estimated glomerular filtration rate (eGFR) data were collected and correlated as well as postoperative complications and recurrence. We could identify 47 patients managed by PN for radiologically confirmed >4 cm renal masses. The mean age of the patients was 55.7 ± 13.4, including 29 males and 18 females. Masses were T1b and T2 in 40 and 7 patients, respectively. The mean tumor size was 6.2 ± 1.5 cm. Using renal nephrometry score; 8, 28, and 11 had low, moderate, and high complexity, respectively. Renal cell carcinoma (RCC) was identified in 42 patients. Five patients out of 42 cancerous cases (12%) had pathological T3 RCC. The mean preoperative and postoperative eGFR were 89.09 ± 12.41 and 88.50 ± 10.50, respectively (P 0.2). The median follow-up was 14 months and within that short time, no patient had evidence for cancer recurrence. PN for large renal masses is safe in experienced hands and should be attempted in a higher percentage of patients, regardless of the tumor complexity. No cancer recurrence or deterioration of renal function was observed within our short-term follow-up.

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